LONG-TERM RESULTS OF PERCUTANEOUS ENDOPYELOTOMY IN THE TREATMENT OF CHILDREN WITH FAILED OPEN PYELOPLASTY

Purpose: We reviewed our experience with the safety and long-term effi cacy of percutaneous endopyelotomy in children with secondary ureterop elvic junction obstruction who previously underwent open pyeloplasty. Materials and Methods: Nine patients a median of 7 years old underwent endopyelotomy between June 1985 and July 1995. Anderson-Hynes pyelopl asty had previously been performed in all children. Antegrade endopyel otomy was done with a cold knife in conjunction with balloon dilation in some cases. Postoperative stenting lasted 6 weeks. Results: The med ian interval between pyeloplasty and endopyelotomy was 7.5 months. Mea n operative time was 240 minutes. Percutaneous endopyelotomy was succe ssful in 8 of the 9 patients. One patient who required repeat endopyel otomy after 4 years is presently well at 5 years of followup. Average followup was 5.6 years (range 2 to 10). There was a low morbidity rate , including I case of urinary tract. infection, 1 of pneumonia and 1 t hat required blood transfusion. Conclusions: Percutaneous antegrade en dopyelotomy is a safe, effective and durable alternative for children who previously underwent unsuccessful pyeloplasty.